García-Muntión A, Godefroy L, Robert H, Muñoz-García D, Calvo-Lobo C, López-de-Uralde-Villanueva I. Study of the mechanisms of action of the hypoalgesic effect of pressure under shock waves application: A randomised controlled trial.
Complement Ther Med 2018;
42:332-339. [PMID:
30670263 DOI:
10.1016/j.ctim.2018.12.012]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/29/2018] [Accepted: 12/17/2018] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE
To determine if the perceived pain intensity during the application of shock waves (SWs) is a determinant mechanism in producing hypoalgesic changes in pressure pain thresholds (PPTs) in asymptomatic individuals.
DESIGN
A randomised, single-blind controlled trial [NCT03455933].
SETTING
University.
PARTICIPANTS
Sixty-three asymptomatic individuals.
INTERVENTIONS
Participants were randomised into three groups: 1-SWs causing mild pain (SW-DP); 2-SWs generating moderate pain (SW-MP); and 3-cold pressor test (CPT).
MAIN OUTCOME MEASUREMENTS
Before and after the intervention, the PPT was evaluated bilaterally at the following points: lateral epicondyle, median nerve in the flexure of the elbow, and tibia.
RESULTS
The results showed differences between various groups over time for all PPTs assessments, due to the existence of statistically significant differences in the interaction group x times (dominant arm lateral epicondyle [P < 0.001; η2p = 0.255]; dominant arm median nerve [P = 0.001; η2p = 0.212]; nondominant arm lateral epicondyle [P < 0.001; η2p = 0.275]; nondominant arm median nerve [P < 0.001; η2p = 0.268]; tibia [P = 0.012, η2p = 0.138]). The SW-MP group obtained a significant increase in all the PPT evaluations compared with the SW-DP group (d > 0.80). The CPT group only showed significantly higher results, and of high magnitude (d > 0.80), regarding the SW-DP group for the PPT evaluation in the dominant member. The SW-MP group showed differences compared with the CPT only for the PPT obtained in the nondominant arm.
CONCLUSIONS
The findings show that SW treatment generates a hypoalgesic effect on the application point, with moderate pain. Further studies are necessary in order to link these hypoalgesic changes to the activation of the descending inhibitory systems.
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